Insurance says I'm not covered for ambulance ride?

[Carol]

Hey all, has anyone seen this?

Some time ago I was in a bicycle accident in Mass. that wrenched up my neck. I was out on a bike trail and the wreck left me too dizzy to stand, let alone ride the 10 or so miles back to my car. Another bicyclist called paramedics. Wasn't well prepared for the accident, I had nothing with me other than car keys and a cell phone...naturally I didn't have my insurance card.

I ended up taking a rather expensive ambulance ride because the trauma center nearest me had a power outage and couldn't do a CT scan. They couldn't take me to the next-closest one, despite it being 3 miles from my car, because that would mean crossing state lines in to NH and they couldn't do that. So now I have a $800 bill in collections for this ride.

My insurance company said my insurance was CANCELLED at the time of the accident? There's no way this is possible. I have insurance the usual way, through my employer paid for with premiums deducted from my paycheck. They paid for my ER visit but not for the ride to the hospital. Anyone seen this before?

 

[DennisBreene]

I'm not surprised. The insurance company refers to any payouts for claims as "loses", and many of them try to deny as much as they can on the first go round. Appeal it. Then appeal again if it fails to go through. Talk to the ambulance co. or whoever billed for the ride and explain your situation and see if you can start making payments while waiting for the appeal. Making arrangements for payments and then making those payments will usually stop the collections process and keep your credit rating from getting dinged. Often medical establishments are very liberal on the payment amounts as long as you don't miss payments.

 

[Dirty Dog]

That's just an insurance company being an insurance company. I'm told, by a family member who works for one, that they will just reject a certain percentage of claims knowing that the policy holder will pay it.
Some years ago, Sue and I were in a motorcycle wreck. Both busted up a bit, as you might imagine. Sue needed surgery. We are insured through the hospital where we work. She was in that hospital. Had surgery at that hospital. With an anesthesiologist who works at that hospital.
The insurance company claimed it was "out of network"...
Appeal and appeal again.

 

[DennisBreene]

Also, contact your employer's human resource dept. They can often assist in adjusting the perceptions of the insurance co.

 

[arnisador]

We've appealed with success before. Appeal away!

 

[oftheherd1]

Appeal for sure. Where I am at, we don't have to pay for an ambulance ride. Some counties are trying to set up billing for ambulance transport. And of course it is OK; you don't have to pay since your insurance will. What was the question in your thread opener? :uhyeah:

As an aside, it is just another cheap politician's trick. You won't be filled directly, but your insurance premiums will have to go up to cover the added costs insurance will have to pay. If they include that in their coverage.

 

[arnisador]

Some counties are trying to set up billing for ambulance transport.

In my experience this is pretty standard now.

 

[jezr74]

I know in Australia you need to have ambulance cover stipulated in your policy.

If you were of sound mind, and did not call the ambulance and did not have someone call on your behalf your might not liable for the cost.

This was valid when I used to be a St. Johns volunteer, you had to all the person of they wanted an ambulance called for them. Unless they were incapable of making the decision. Otherwise if could come out of your own sky rocket.

Sent from my Nexus 7 using Tapatalk HD

 

[Steve]

I'm sorry you're going through this, Carol. When I hear stories like this it really makes me angry. I just don't understand how anyone would suggest we have even good healthcare in this country, much less the oft touted "best healthcare in the world." Our current system is just completely broken. People are literally fleeced by the insurance companies, whom we all know are making health care decisions based upon a bottom line, protecting their shareholders over the wellness of the insured.

It's infuriating. The system is intentionally unintelligible. No one wants to know how deep the corruption goes, as long as everyone gets their piece of the pie, gaming the system at the expense of the patient.

But we protect our healthcare system at all costs. I just don't get it. If we had a single payer system, your ride would have been covered.